Postmortem Change and its Effect on Evaluation of Fractures

Abstract

Postmortem changes can both mask and mimic trauma, impairing interpretation of the injuries. Bones, while capable of surviving the postmortem period relatively intact, are not immune from these effects. Without attached soft tissue to aid an examiner, it can be difficult to determine the time frame of a fracture's occurrence (i.e., before death, at death, or after death). Bones are composed of both organic and inorganic material, each of which contribute to the biomechanical properties of the bones. With the loss of organic material, the biomechanical response of bones to trauma changes; however, the organic material can remain a part of the bone for an extended period after death. Bone with intact organic material is wet bone, and bone without the organic material is dry bone, and because of this difference, fractures of wet bone can appear different than fractures of dry bone. Important in distinguishing the two are differential coloration, various features of the fracture itself (e.g., angle, surface, outline), surrounding flaking of the cortex, and incomplete separation of bone fragments from the fracture. However, the changes are not absolute, and determination of the two types of fractures can be problematic. Although the terms antemortem, perimortem, and postmortem have been used to describe the general time frame of fractures in relation to the time of death of the individual, because of confusion among specialties regarding the definition of "perimortem," its use may best be discontinued in favor of a descriptive approach when fractures are identified in skeletal remains.

State-of-the-Art on Wound Vitality Evaluation: A Systematic Review

“…One of the main problems in this field is represented by the immediate post-mortem period, a phase characterized by the persistence of vital reactions (so-called "residual-life phenomena") within a very short time after death [163,164]. In fact, metabolic processes and vital activities do not cease in all the cells and tissues at the same time; so, immediately after death, they could mimic vital reactions, making it hard to differentiate vital from early post-mortem findings [165]. This problem involves a wide range of techniques used in wound vitality evaluation, from immunohistochemistry to miRNAs and proteomics.…”

Classification of Post-Mortem Changes and Factors Affecting It

“…Differential colouring, the fracture's individual characteristics such as its angle, surface, and contour, the cortex's surrounding flakes, and the inadequate separation of bone fragments from the fracture are all essential in separating the two. The two types of fractures can be hard to distinguish since the changes are not absolute (16).…”

Cioclovina fractures: Reply to Soficaru and Trinkaus: Perimortem versus postmortem damage: The recent case of Cioclovina 1, Am J Phys Anthropol 2020 172, 135–139

“…Soficaru and Trinkaus' theory is completely incompatible with the morphology and configuration of the Cioclovina fractures. Such postmortem damage on dry, much less fossilized, bone would have produced a very different pattern of fractures from that observed on Cioclovina due to changes in bone biomechanical properties, as extensively stated in the literature on the topic (e.g., _ Işcan & Steyn, 2013); Kemp, 2016;Kristensen et al, 2014;Moritz, 1954) and recently confirmed experimentally (Ribeiro et al, 2020). The configuration presented by Cioclovina (linear fracture and depressed fracture with concentric and radiating fractures) requires the bone to be viscoelastic, and therefore fresh, and is by definition perimortem (Kristensen et al, 2014;Moritz, 1954;_ Işcan & Steyn, 2013).…”